Pharmacology-cardiovascular-diltiazem
Terms
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- Which Class of antiarrhythmic is diltiazem in?
- IV
- A brand name for diltiazem is?
- Cardizem
- Diltiazem is what kind of agent?
- calcium channel blocker
-
What is the MOA of diltiazem?
slowed impulse through AV node...what does this do to atria?
decreases both -
slows influx of calcium ions into smooth muscle cells....what does this result in?
atria don't beat too fast... what does this action do to arterial resistance and oxygen demand? - What are the therapeutic effects of diltiazem?
-
antianginals
antiarrhythmic Class IV
antihypertensive - Diltiazem is indicated for?
-
hypertension
angina pectoris and
vasospastic (Prinzmetal's)
angina
supraventricular
tachyarrhythmias and rapid
ventricular rates in
atrial flutter or
fibrillation
management of Raynaud's
syndrome -
Therapeutic effects of diltiazem?
Where does vasodilation occur? - systemic and coronaries...decreases anginal attacks and suppresses arrhythmias
- Diltiazem is contraindicated in?
-
hypersensitivity
sick sinus syndrome
2nd-or 3rd-degree AV block
(unless an artificial PM
is in place)
blood pressure is less than
90 mmHg
recent MI or pulmonary
congestion
concurrent use of RIFAMPIN - How does grapefruit juice effect interaction?
- increases serum levels and effect
- Monitor blood pressure of diltiazem?
- continuously
- Monitor ECG because diltizem?
- may cause prolonged PR interval
- Besides blood pressure and ECG, what else should be monitored?
-
I & O
daily weight - Assess for signs of CHF which are?
-
peripheral edema
rales/crackles
dyspnea
weight gain
jugular venous distention - Monitor frequency of prescription refills to determine?
- adherence
- If taking diltiazem and digoxin concurrently, check for?
- digoxin toxicity
-
Monitor ECG continuously because nurse is looking for?
bradycardia or prolonged hypotension - arrhythmias...what should be reported promptly?
- Monitor serum potassium periodically...because?
- hypokalemia increases risk of arrhythmias and should be corrected
- Total serum calcium concentrations are NOT affected by?
- calcium channel blockers
- Monitor renal and hepatic functions periodically during long-term therapy. May cause increase in?
- hepatic enzymes after several days of therapy, which return to normal on d/c of therapy
- Instruct patient on correct technique for monitoring pulse. Instruct patient to contact hcp if heart rate is less than?
- 50 bpm
- Patient should move slowly due to?
- hypotension
- See dentist for frequent teeth cleaning due to?
-
tenderness
bleeding
gingival hyperplasia
(gum enlargement) - Don't use cough meds, alcohol, or OTC meds without?
- consulting hcp
- Have patient notify hcp when?
-
irregular heartbeats
dyspnea
swellingn of hands and feet
pronounced dizziness
nausea
constipation
hypotension
headache is severe or
persistent - To prevent photosensitivy, caution patient to?
-
wear protective clothing
use sunscreen - Instruct patient on concurrent nitrate or beta-blocker therapy to continue taking both meds as directed and to use SL nitro as needed for anginal attacks.
- !
- Advise patient to contact hcp if? (5)
-
chest pain doesn't improve
worsens after therapy
occurs with diaphoresis
shortness of breath occurs
severe, persistent headache - Caution patient to discuss exercise restrictions with who before exertion?
- hcp
- Meds don't cure hypertension, so encourage patient with the following interventions?
-
weight reduction
low-sodium diet
smoking cessation
moderation of alcohol
consumption
regular exercise
stress management - Effectiveness of therapy is demonstrated by?
-
decrease in blood pressure
decrease in frequency and
severity of anginal attacks
decrease in need for nitrate
therapy
increase in activity
tolerance and sense of well
being
suppression and prevention
of tachyarrhythmias